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  • Question 1 - A dermatological examination on a patient presenting with a skin lesion which shows...

    Correct

    • A dermatological examination on a patient presenting with a skin lesion which shows a solid, well circumscribed, lump measuring 0.8 cm in diameter. Which one of these best describes the lump you have found on examination?

      Your Answer: Papule

      Explanation:

      Macule— a small patch of skin that is altered in colour, but is not elevated.

      Patch — a large area of colour change, with a smooth surface.

      Papule— elevated, solid, palpable lesion that is ≤ 1 cm in diameter. They may be solitary or multiple. Papules may be:

      Nodule — elevated, solid, palpable lesion > 1 cm usually located primarily in the dermis and subcutis (deeper layers of the skin). The greatest portion of the lesion may be above or beneath the skin surface.

      Vesicle — a small blister. It is a circumscribed lesion ≤ 1 cm in diameter that contains liquid (clear, serous or haemorrhagic).

      Cyst — papule or nodule that contains fluid or semi-fluid material so is fluctuant

      Plaque — a circumscribed, palpable lesion more than 1 cm in diameter; most plaques are elevated.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9.9
      Seconds

  • Question 2 - A 53-year-old male has presented to your clinic with the complaint of a...

    Incorrect

    • A 53-year-old male has presented to your clinic with the complaint of a rash on his right forearm. On examination, you discover small reddish-purple spots on the skin measuring less than 2-3 mm. They do not blanch on applying pressure.

      Which one of the following best fits the description given above?

      Your Answer: Purpura

      Correct Answer: Petechiae

      Explanation:

      Petechiae are small red or purple spots on the skin measuring less than 3 mm, caused by minor haemorrhages which do not blanch on applying pressure.
      Purpura measures between 3mm and 1 cm in diameter, while ecchymoses are greater than 1 cm in diameter. Both are caused due to haemorrhage.

      Erythema is the generalised redness of the skin.

      A macule is a flat, discoloured area of the skin measuring less than 1 cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      18.9
      Seconds

  • Question 3 - A 57-year-old woman has presented with cough and shortness of breath. Her GP...

    Incorrect

    • A 57-year-old woman has presented with cough and shortness of breath. Her GP had done some blood tests recently and told her that she had a positive ANA result.

      Which of these statements is true about anti-nuclear antibodies (ANAs)? Select only ONE answer.

      Your Answer: Anti-double stranded DNA (Anti-DsDNA) is suggestive of drug-induced lupus.

      Correct Answer: The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome

      Explanation:

      Anti-nuclear antibodies are auto-antibodies directed against a variety of nuclear antigens. There are different staining patterns and each pattern is suggestive of a different disorder.

      Speckled staining is suggestive of mixed connective tissue disease.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-double stranded DNA is suggestive of SLE while anti-histone antibodies are suggestive of drug-induced lupus.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most accurate.

      The presence of ANAs in rheumatoid arthritis is suggestive of Felty’s syndrome. Felty’s syndrome is characterized by a combination of rheumatoid arthritis, splenomegaly and neutropenia.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      31.2
      Seconds

  • Question 4 - A 30-year-old male with a known allergy to natural latex rubber presents with...

    Correct

    • A 30-year-old male with a known allergy to natural latex rubber presents with an allergic reaction to a food he has just eaten.

      Which ONE of these foods is most likely to cause an associated hypersensitivity in him?

      Your Answer: Banana

      Explanation:

      About one third of patients with allergy to natural latex rubber (NRL) have an associated allergy to some plant-derived foods. It is known as the latex-fruit syndrome and occurs commonly with consumption of fresh fruits. Banana and avocado are the most implicated fruits but it can also be seen with tomato, kiwi and chestnut.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.6
      Seconds

  • Question 5 - A 45-year-old African American male presents to your clinic complaining of swelling of...

    Correct

    • A 45-year-old African American male presents to your clinic complaining of swelling of his feet for the past six months. On examination, there is periorbital and pedal oedema. A 24-hour urine collection is ordered, which shows 8 g of protein. The serum cholesterol is ten mmol/L. You order a renal biopsy to confirm the diagnosis.

      Which one of the following findings are you most likely to see in this patient's biopsy?

      Your Answer: Focal segmental glomerulosclerosis

      Explanation:

      This patient has Nephrotic Syndrome confirmed by the presence of 1. Heavy proteinuria (greater than 3-3.5 g/24 hours)
      2. Hypoalbuminemia (serum albumin < 25 g/L)
      3. Generalised oedema (often with periorbital involvement)
      4. Severe hyperlipidaemia (total cholesterol is often > 10 mmol/L).

      Focal Segmental Glomerulosclerosis will be the most likely answer as it is the most common cause of Nephrotic Syndrome in African American adults.

      Minimal change disease is the most common cause of nephrotic syndrome in children.

      Membranous glomerulonephritis is the most common cause of Nephrotic Syndrome in Caucasian adults.

      In IgA nephropathy, patients will complain of cola-coloured urine.

      Mesangiocapillary glomerulonephritis presents with features of Nephritic Syndrome.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      22.2
      Seconds

  • Question 6 - A 20-year-old male receives a small cut over his hand while climbing a...

    Correct

    • A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?

      Your Answer: Platelet plug formation

      Explanation:

      Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps:

      1) Primary haemostasis – formation of a weak platelet plug
      – The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area
      – the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug
      – the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factor

      Any damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.

      2) Secondary haemostasis
      3) Fibrinolysis

      Fibrin (factor Ia) is a long, thin protein with branches produced at the end of the coagulation cascade when fibrinogen (factor I) is converted to fibrin, which stabilizes the blood clot.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      15.1
      Seconds

  • Question 7 - A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was...

    Correct

    • A 56-year-old male with a 10-year history of Diabetes Mellitus and Hypertension was rushed to the Emergency Department due to sudden onset crushing chest pain. ECG showed an ST-elevation myocardial infarct in the left anterior descending artery territory. The patient's condition was stabilised and managed with angioplasty, but he sustained significant myocardial damage.

      Which one of the following statements best agrees with the myocardial healing process?

      Your Answer: The left ventricle will likely hypertrophy first to maintain cardiac output

      Explanation:

      Following a myocardial infarction scar tissue formation will take place at the site of the damaged muscle. This places increased load on the rest of the myocardium causing it to hypertrophy. The left ventricle will hypertrophy first as it is pumping blood against a greater afterload as compared to the right ventricle.

      There are three types of cells in the body with regards to the cell cycle: 1. permanent
      2. labile
      3. stable cells

      Permanent cells do not re-enter the cell cycle and remain in G0. If there is a pool of stem cells the stem cells will enter the cell cycle to form more cells. Myocardial cells are a type of permanent cell and there is no pool of stem cells in the heart muscle. The anterior wall will not hypertrophy as it is formed by the right atrium and ventricle and both of these hypertrophy after the left ventricle.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      13.7
      Seconds

  • Question 8 - A dermatological examination of a patient presenting with a lump shows a visible...

    Correct

    • A dermatological examination of a patient presenting with a lump shows a visible collection of fluid measuring 0.3 cm in diameter.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Vesicle

      Explanation:

      A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter.

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A carbuncle is a collection of individual boils clustered together.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9
      Seconds

  • Question 9 - The following statements about leukotrienes as chemical mediators of the acute inflammatory response...

    Correct

    • The following statements about leukotrienes as chemical mediators of the acute inflammatory response are all true EXCEPT?

      Your Answer: They decrease vascular permeability

      Explanation:

      Leukotrienes increases (not decrease) vascular permeability during acute inflammation.

      All the other statements are correct

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      21.9
      Seconds

  • Question 10 - A 2nd-year medical student is solving an exam paper with questions about the...

    Correct

    • A 2nd-year medical student is solving an exam paper with questions about the immune system. She comes across a question regarding innate immunity. Innate immunity is the immunity naturally present within the body from birth.

      Which ONE of the following is not a part of this type of immunity?

      Your Answer: Antibody production

      Explanation:

      Innate immunity, also called non-specific immunity, refers to the components of the immune system naturally present in the body at birth.

      The components of innate immunity include:
      1) Natural Killer Cells
      2) Neutrophils
      3) Macrophages
      4) Mast Cells
      5) Dendritic Cells
      6) Basophils.

      Acquired or adaptive immunity is acquired in response to infection or vaccination. Although the response takes longer to develop, it is also a more long-lasting form of immunity.

      The components of this system include:
      1) T lymphocytes
      2) B lymphocytes
      3) Antibodies

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.1
      Seconds

  • Question 11 - A 20-year-old male has an anaphylactic reaction following a wasp sting.

    What type of...

    Correct

    • A 20-year-old male has an anaphylactic reaction following a wasp sting.

      What type of hypersensitivity reaction is this?

      Your Answer: Type I

      Explanation:

      Anaphylaxis is an example of a type I hypersensitivity reaction.

      It is IgE mediated.

      It requires a prior exposure to the antigen. The initial exposure sensitizes the body to the antigen and a second exposure to that antigen leads to an anaphylactic reaction.

      Massive calcium influx into the cells leads to mast cell degranulation.

      The Immunoglobulin antigen complex binds to Fc receptors on the surface of mast cells. The result is mast cell degranulation and release of histamine, proteoglycans and serum proteases from cytoplasmic granules.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      4.8
      Seconds

  • Question 12 - A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests...

    Correct

    • A 62-year-old woman has reduced urine output, nausea, and confusion. Renal function tests and other investigations done leads to a diagnosis of acute kidney injury (AKI). Which one of these is consistent with a diagnosis of AKI?

      Your Answer: A rise in serum creatinine of 26 μmol/L within 48 hours

      Explanation:

      AKI is diagnosed based on an acutely rising serum creatinine and/or reduction in urine output.

      • AKI can often be non-oliguric.

      AKI is present if any one or more of the following criteria is met:

      • A rise in serum creatinine of ≥26 micromol/L (≥0.3 mg/dL) within 48 hours

      • A rise in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the past 7 days (in practice you can use the lowest value from the past 3 months as the baseline for the patient)

      • Urine volume <0.5 ml/kg/hour for at least 6 hours.

       

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      13.6
      Seconds

  • Question 13 - A 66-year-old patient attends the Emergency Department with chest pain. His ECG and...

    Incorrect

    • A 66-year-old patient attends the Emergency Department with chest pain. His ECG and troponin are suggestive of a new myocardial infarction. You have explained the condition and the prognosis. He asks you about how the damaged area of his heart will heal following this.
      Which answer best describes the process of myocardial healing following myocardial infarction? Select ONE answer only.

      Your Answer: The damaged cells will hypertrophy to maintain cardiac output

      Correct Answer: The damaged myocardium will form non-contractile scar tissue

      Explanation:

      Myocardial cells are unable to regenerate, they are unable to divide in response to tissue injury. The remain permanently in G0 and cannot progress to G1. If a segment of muscle dies, for example in myocardial infarction, this tissue will be replaced by scar tissue if the patient recovers. This scar tissue is non-contractile and therefore the remaining myocardium must work harder to maintain cardiac output. As a consequence the remaining undamaged myocardium undergoes compensatory hypertrophy without cell division.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      19.5
      Seconds

  • Question 14 - Which one of the listed cells are typically found in a granuloma? ...

    Correct

    • Which one of the listed cells are typically found in a granuloma?

      Your Answer: Epithelioid cells

      Explanation:

      Typically, a granuloma has Langhan’s cells (large multinucleated cells) surrounded by epithelioid cell aggregates, T lymphocytes and fibroblasts.

      Antigen presenting monocytic cells are found in the skin are known as Langerhan’s cells.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.4
      Seconds

  • Question 15 - A 20-year-old female presents with painful wrist following a fall while skating. X-rays...

    Correct

    • A 20-year-old female presents with painful wrist following a fall while skating. X-rays shows fracture of the ulna.

      The initial phase of bone healing is?

      Your Answer: Haematoma at the fracture site

      Explanation:

      Haemorrhage occurs into the fracture site from the ruptured vessels in the bone marrow and those supplying the periosteum immediately after fracture. This hematoma formation is the first phase of bone healing.

      The 4 stages of bone healing are:
      Haematoma at the fracture site (provides a framework for healing)
      Callus formation
      Lamellar bone formation
      Remodelling

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      6.2
      Seconds

  • Question 16 - A 67-year-old female presents with a history of morning stiffness and arthritis of...

    Correct

    • A 67-year-old female presents with a history of morning stiffness and arthritis of her hand joints. She is being investigated for rheumatoid arthritis.

      Which test is most sensitive and specific for this diagnosis?

      Your Answer: Anti-CCP

      Explanation:

      Anti-cyclic citrullinated peptide (anti-CCP) is an antibody present in 60-80% of rheumatoid arthritis patients. It is measured by enzyme-linked immunosorbent assay (ELISA). It may be present years before the onset of the disease and is associated with a more severe disease course.

      While most patients with anti-CCP antibodies are also positive for rheumatoid factor (RF), RF antibody is not specific for rheumatoid arthritis as it can occur in patients with other conditions such as infections and other autoimmune conditions.

      ESR, antinuclear antibodies(ANA) and Synovial fluid examination are not specific for rheumatoid arthritis.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      8.4
      Seconds

  • Question 17 - Innate, or non-specific, immunity is the immune system we are born with.
    Which of...

    Correct

    • Innate, or non-specific, immunity is the immune system we are born with.
      Which of the following is NOT an example of innate immunity? Select ONE answer only.

      Your Answer: T-lymphocytes

      Explanation:

      Innate, or non-specific, immunity is the immune system we are born with.
      There are three aspects of innate immunity:
      1. Anatomical barriers, such as:
      The cough reflex
      Enzymes in tears and skin oils
      Mucus – which traps bacteria and small particles
      Skin
      Stomach acid
      2. Humoral barriers, such as:
      The complement system
      Interleukin-1
      3. Cellular barriers, such as:
      Neutrophils
      Macrophages
      Dendritic cells
      Natural killer cells
      Antibody production is part of the specific, or inducible immune response. T-lymphocytesare responsible for the cell mediated immune response which is part of specific, or inducible immunity.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.2
      Seconds

  • Question 18 - A patient presents with a rash for dermatological examination. A large area of...

    Correct

    • A patient presents with a rash for dermatological examination. A large area of purplish discolouration of the skin that measures 2 cm in diameter and does not blanch when pressure is applied is seen .

      What is the best description of this rash that you have found on examination?

      Your Answer: Ecchymoses

      Explanation:

      Ecchymosis are discolouration of the skin or mucous membranes caused by extravasation of blood. They are usually red or purple in colour and measure greater than 1 cm in diameter and do not blanch on applying pressure.

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.

      Petechiae are discolouration of the skin measuring less than 3 mm in diameter

      Purpura are discolouration of the skin measuring between 0.3 cm and 1 cm in diameter.

      Erythema is redness of the skin or mucous membranes caused by hyperaemia of superficial capillaries caused by skin injury, infection or inflammation. Erythema blanches when pressure is applied whereas ecchymosis, purpura and petechiae do not.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      14.5
      Seconds

  • Question 19 - A newborn baby is referred by the community midwife who is concerned the...

    Correct

    • A newborn baby is referred by the community midwife who is concerned the baby is jaundiced because of the yellow appearance of his eyes and skin following a postnatal home visit. The jaundice is visible in the baby’s feet making her worried.

      Jaundice are visible in the extremities of neonates at what approximate threshold bilirubin level?

      Your Answer: 255 μmol/L

      Explanation:

      Newborn babies have a higher concentration of red blood cells with shorter lifespan leading to higher bilirubin levels than in adults. This condition is short-lived and harmless but with potential serious causes that need to be assessed for if present.

      The most obvious physical sign of jaundice is a yellow discolouration of the sclera, skin and mucous membranes. At a bilirubin level of 35 μmol/L or higher, the eye is affected. The bilirubin level will need to be higher than 255 μmol/L for the feet and extremities to be affected.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      7.7
      Seconds

  • Question 20 - A 27-year-old female is brought to the Emergency Department by ambulance with extensive...

    Correct

    • A 27-year-old female is brought to the Emergency Department by ambulance with extensive bleeding from her upper arm following a fall from a bicycle onto a fence. On inspection her biceps brachii muscle has been lacerated.
      How will the muscle heal from this injury? Select ONE answer only.

      Your Answer: Satellite cells will produce a small number of regenerated myocytes

      Explanation:

      Muscle heals with fibrous tissue to form a scar. Once cut, it will never regain its previous bulk or power. Within the scar a small number of myocytes (muscle cells) may be seen, which are formed from satellite cells but they contribute little to the function of the muscle overall.
      In more widespread ischaemic injury, such as critical ischaemic limb due to arterial compromise, or in compartment syndrome, damaged myocytes are replaced diffusely with fibrous tissue. This fibrous tissue contracts and reduces movement, and in extreme cases can pull the limb into abnormal positions such as in Volkmann’s ischaemic contracture of the forearm.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.7
      Seconds

  • Question 21 - Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that...

    Correct

    • Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus.

      Which ONE of these statements about ANAs is true?

      Your Answer: They can be of any immunoglobulin class

      Explanation:

      Anti-nuclear antibodies(ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus. They can be of any immunoglobulin class.

      CREST syndrome is usually associated with anti-centromere antibodies.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most reliable.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-dsDNA antibodies are found in 80 – 90% of patients with SLE

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      17
      Seconds

  • Question 22 - A 54-year-old man who is acutely unwell has his blood sent for test...

    Correct

    • A 54-year-old man who is acutely unwell has his blood sent for test and the results come back with a CRP of 115.

      Which of these statements about C-reactive protein is FALSE?

      Your Answer: It is produced in the bone marrow

      Explanation:

      C-reactive protein(CRP) is synthesized in the liver in response to increased interleukin-6 (IL-6) secretion by macrophages and T-cells.
      Some conditions that cause CRP levels to a rise include: bacterial infection, fungal infection, severe trauma, autoimmune disease, Organ tissue necrosis, malignancy and surgery.

      It is useful in the clinical setting as a marker of inflammatory activity and can be used to monitor infections.

      CRP levels start to rise 4-6 hours after an inflammatory trigger and reaches peak levels at 36-50 hours.

      In the absence of a disease process, the normal plasma concentration is less than 5 mg/l.

      CRP is useful for monitoring inflammatory conditions (e.g. rheumatoid arthritis and malignancy), can be used as a prognostic marker in acute pancreatitis, and serial measurement can be used to recognize the onset of nosocomial infections in the intensive care settling.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      22.3
      Seconds

  • Question 23 - A 29-year-old woman with anaphylactic reaction to peanuts, had to use her EpiPen...

    Correct

    • A 29-year-old woman with anaphylactic reaction to peanuts, had to use her EpiPen on the way to hospital.

      What percentage of patients with anaphylactic reaction suffer a biphasic response?.

      Your Answer: 20%

      Explanation:

      About 20% of patients that suffer an anaphylactic reaction suffer a biphasic response 4-6 hours after the initial response (sometimes up to 72 hours after).

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      7.6
      Seconds

  • Question 24 - A patient presents with a rash for a dermatological examination. A flat circumscribed...

    Incorrect

    • A patient presents with a rash for a dermatological examination. A flat circumscribed area of discoloured skin measuring 0.7 cm in diameter is seen on examination.

      What is the best description of this rash that you have found on examination?

      Your Answer: Papule

      Correct Answer: Macule

      Explanation:

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.

      A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.

      A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter.

      A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.

      A plaque is a palpable skin lesion that is elevated and measures >1cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.8
      Seconds

  • Question 25 - A dermatological examination on a patient presenting with a lump shows a small...

    Correct

    • A dermatological examination on a patient presenting with a lump shows a small visible skin elevation containing an accumulation of pus.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Pustule

      Explanation:

      A pustule is a small visible skin elevation containing an accumulation of pus.

      A carbuncle is a collection of individual boils clustered together.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A vesicle is a visible collection of fluid measuring less than 0.5 cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      5.3
      Seconds

  • Question 26 - A 6-year-old girl is brought to the nephrology clinic by her mother due...

    Correct

    • A 6-year-old girl is brought to the nephrology clinic by her mother due to facial oedema. Her lab workup shows proteinuria of 7 g/24 hours and serum albumin levels of 15 g/L. A diagnosis of Nephrotic Syndrome is made, and corticosteroid therapy is initiated.

      Which one of the following is the most likely cause of nephrotic syndrome in this patient?

      Your Answer: Minimal change disease

      Explanation:

      Minimal Change Disease is the most common cause of Nephrotic Syndrome in the paediatric population. It may be caused by NSAID use. Electron microscopy shows the fusion of foot processes while light microscopy will appear normal.

      Focal segmental glomerulosclerosis causes Nephrotic Syndrome in adults. It is associated with Heroin use and HIV infection. There is a limited response to steroids, and the disease progresses to end-stage renal failure in 5-10 years.

      Diabetic nephropathy occurs after a long period of diabetes due to the deposition of amyloid protein leading to a decrease in glomerular filtration.

      There is no history of Hepatitis B in this patient and no symptoms of liver disease such as jaundice.

      Membranous glomerulonephritis would present with features of Nephritic Syndrome. These would be oedema, haematuria; red blood cell casts in the urine and hypertension.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.4
      Seconds

  • Question 27 - A newborn baby is rushed to the neonatal ICU 4 hours after birth...

    Correct

    • A newborn baby is rushed to the neonatal ICU 4 hours after birth due to sudden onset severe jaundice and generalised oedema. Family history reveals that this is the second baby, while blood testing shows that the mother has an Rh-negative blood group while the baby is Rh-positive. A diagnosis of haemolytic disease of the newborn is established.

      Which one of the following hypersensitivity reactions have occurred in this case?

      Your Answer: Type II hypersensitivity reaction

      Explanation:

      Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.

      When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.

      TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)oxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.
      Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      14.9
      Seconds

  • Question 28 - A patient presents to your Emergency Department with a laceration on their buttocks...

    Correct

    • A patient presents to your Emergency Department with a laceration on their buttocks requiring closure with sutures.

      What stage of wound healing is the first to reach completion?

      Your Answer: Haemostasis

      Explanation:

      The stages of wound healing are: haemostasis, inflammatory, proliferative and remodelling (maturation) phases in that order. The first stage in the healing process of a laceration is haemostasis. Haemostasis is the process of the wound being closed by clotting.

      The inflammatory phase occurs just after and up to 48 hours after injury– Blood vessels dilate to allow white blood cells, antibodies, growth factors, enzymes and nutrients to reach the wounded area leading to the characteristic signs of inflammation seen.

      Epithelialisation and angiogenesis are not phases of wound healing but occur during the proliferative phase. This ia after haemolysis and inflammation phases have occurred.

      The maturation phase is the final phase and occurs when the wound has closed. It involves remodelling of collagen from type III to type I. Apoptosis remove unwanted cells, cellular activity reduces and the number of blood vessels in the wounded area regresses and decreases. This can continues for up to 1 year after injury.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      7.4
      Seconds

  • Question 29 - A 29-year-old female with a swollen red finger presents to your clinic and...

    Correct

    • A 29-year-old female with a swollen red finger presents to your clinic and you suspect that the underlying process is of acute inflammation. You request for some bloods investigations.

      Which statement about histamine as a chemical mediator of the acute inflammatory response is TRUE?

      Your Answer: It increases vascular permeability

      Explanation:

      Histamine increases vascular permeability in the acute inflammatory response.

      Histamine causes vasodilation.

      It is released from Mast cells and basophils, eosinophils and platelets.

      Mast cells and basophils are its primary source

      Nitric oxide (not histamine) is a major factor in endotoxic shock

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      23.7
      Seconds

  • Question 30 - A 57-year-old male presents to the orthopaedic clinic complaining of pain and swelling...

    Incorrect

    • A 57-year-old male presents to the orthopaedic clinic complaining of pain and swelling in the left knee joint. On examination, the left knee is swollen, tender and erythematous. The patient is booked for joint aspiration, and a diagnosis of pseudogout is made following the aspiration.

      Which types of crystals would be seen in the joint aspirate to lead to this diagnosis?

      Your Answer: Positively birefringent needle-shaped crystals

      Correct Answer: Positively birefringent brick-shaped crystals

      Explanation:

      Gout and pseudogout are both characterised by crystal deposition in the affected joints. The deposition of urate crystals causes gout, while calcium pyrophosphate crystals cause pseudogout. The crystals can be distinguished microscopically because urate crystals are negatively birefringent needle-shaped crystals, whilst calcium pyrophosphate crystals are positively birefringent brick-shaped crystals.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      30.1
      Seconds

  • Question 31 - A patient presents with a lump for a dermatological examination. There is a...

    Correct

    • A patient presents with a lump for a dermatological examination. There is a circumscribed skin elevation measuring 0.3 cm in diameter seen on examination.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Papule

      Explanation:

      A papule is a solid, well circumscribed, skin elevation measuring less than 0.5 cm in diameter.

      A nodule is a solid, well circumscribed, raised area that lies in or under the skin and measures greater than 0.5 cm in diameter. They are usually painless.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      6.4
      Seconds

  • Question 32 - While studying fluid homeostasis in the body, you encounter the term exudate. Exudate...

    Incorrect

    • While studying fluid homeostasis in the body, you encounter the term exudate. Exudate is a fluid that leaks out of the intravascular space due to changes in the permeability of the microcirculation secondary to inflammation.

      Which ONE of the following conditions would not be listed among the causes of an exudate?

      Your Answer: Chylothorax

      Correct Answer: Myxoedema

      Explanation:

      An exudate is an inflammatory fluid that leaks out of the intravascular space due to increased vascular permeability and intravascular pressure. It is mostly caused by local processes and can occur in the following conditions:
      1) Infection (e.g. pneumonia)
      2) Malignancy
      3) Pericarditis
      4) Collagen vascular diseases, e.g., Rheumatoid Arthritis

      Myxoedema is a state of severe hypothyroidism in which deposition of mucopolysaccharides occurs in the dermis. This causes a transudative effusion, typically in the pretibial region.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      23.9
      Seconds

  • Question 33 - A 2-day-old male is referred to a tertiary care hospital by the community...

    Incorrect

    • A 2-day-old male is referred to a tertiary care hospital by the community midwife after a home visit due to jaundice and dyspnoea. After history and examination, the relevant blood work is performed, and the baby is found to have conjugated hyperbilirubinemia. The paediatric team suspects a hepatic origin for jaundice based on the findings.

      Which one of the following aetiologies is the most likely cause of jaundice in this case?

      Your Answer: Biliary atresia

      Correct Answer: Alpha 1-antitrypsin deficiency

      Explanation:

      The presence of dyspnoea makes alpha-1 antitrypsin deficiency the more likely diagnosis as biliary atresia does not cause respiratory symptoms. Deficiency of the enzyme alpha-1 antitrypsin causes uninhibited elastase activity and a decrease in elastic tissue. This causes liver cirrhosis leading to an elevation of conjugated bilirubin and emphysema in the lungs.

      Rhesus disease, hereditary spherocytosis and breast milk jaundice cause an elevation of unconjugated bilirubin thus ruling it out in this case. Breast milk jaundice occurs due to an inability of the newborn to metabolize the proteins in breast milk.

      Rhesus disease occurs when an Rh negative mother gives birth to an Rh positive baby. The jaundice would have been accompanied by anaemia and oedema.

      Hereditary spherocytosis occurs due to extravascular haemolysis as defective RBCs are removed by the spleen. The patient would present with jaundice, splenomegaly and possibly an aplastic crisis (if Parvovirus B19 infection).

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      39.6
      Seconds

  • Question 34 - A 15-year-old male is admitted to a rehabilitation centre with a history of...

    Correct

    • A 15-year-old male is admitted to a rehabilitation centre with a history of multiple strokes, myopathy and learning disabilities since childhood. He is under the care of a multidisciplinary team, and his genetic testing reports show the presence of a mitochondrial disorder.

      Which one of the following diseases does this patient most likely have?

      Your Answer: MELAS

      Explanation:

      Mitochondrial diseases are a group of disorders caused by dysfunctional mitochondria. Most cases are maternally inherited, as we inherit our mitochondrial DNA from our mothers only, although mutations in nuclear DNA cause some cases.

      Examples of Mitochondrial Diseases include:
      1. Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS)
      2. Mitochondrial epilepsy with ragged red fibres (MERRF)
      3. Leber’s hereditary optic neuropathy (LHON)
      4. Diabetes mellitus and deafness (DAD)
      5. Neuropathy, ataxia, retinitis pigmentosa, and ptosis (NARP)
      6. Leigh syndrome (subacute sclerosing encephalopathy).

      Red-green colour blindness and G6PD deficiency have an X-linked recessive pattern of inheritance.

      Tay-Sachs Disease and spinal muscular atrophy have an autosomal recessive pattern of inheritance.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      8.7
      Seconds

  • Question 35 - What is the average healing time for a femoral shaft fracture under normal...

    Correct

    • What is the average healing time for a femoral shaft fracture under normal circumstances? Choose ONE answer.

      Your Answer: 12 weeks

      Explanation:

      The process of fracture healing occurs naturally after traumatic bone disruption and begins with haemorrhage, then progresses through Inflammatory, reparative, and remodelling stages

      Average healing times of common fractures are:
      Femoral shaft: 12 weeks
      Tibia: 10 weeks
      Phalanges: 3 weeks
      Metacarpals: 4-6 weeks
      Distal radius: 4-6 weeks
      Humerus: 6-8 weeks

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      3.9
      Seconds

  • Question 36 - A patient presents to your clinic with fever of unknown origin. His...

    Correct

    • A patient presents to your clinic with fever of unknown origin. His blood results shows a markedly elevated C-Reactive Protein (CRP) level.

      Which of these is responsible for mediating the release of CRP?

      Your Answer: IL-6

      Explanation:

      C-reactive protein (CRP) is an acute phase protein produced by the liver hepatocytes. Its production is regulated by cytokines, particularly interleukin 6 (IL-6) and it can be measured in the serum as a nonspecific marker of inflammation.

      Although a high CRP suggest an acute infection or inflammation, it does not identify the cause or location of infection.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      7.2
      Seconds

  • Question 37 - A 30-year-old female presented to the Emergency Department after a fall during a...

    Correct

    • A 30-year-old female presented to the Emergency Department after a fall during a hiking expedition caused severe pain in her left arm and wrist drop. An X-ray revealed a mid-shaft fracture of the humerus, which most likely damaged the radial nerve.

      Which one of the following statements best describes the healing process of peripheral nerves?

      Your Answer: Peripheral nerve fibres regenerate at around 1mm per day

      Explanation:

      Peripheral nerves are nerves that lie outside the brain and spinal cord. Peripheral nerves readily regenerate, while central nervous system axonal injury does not spontaneously regenerate.
      If there is damage to the axons of peripheral nerves, the nerves will regenerate at a slow rate of 1 mm per day. The slow regeneration process may lead to muscle atrophy before regeneration is complete.

      Each peripheral nerve has a single cell body that supplies nutrients to the growing nerve fibre. The cell body does not undergo mitosis; only the axon is regenerated.

      Schwann cells of the peripheral nervous system provide support for this process, while the analogous oligodendrocytes of the central nervous system do not. Schwann cells themselves do not cause regeneration. Schwann cells provide myelin for myelinated fibres and surround non-myelinated fibres with their cytoplasm.

      If an axon is completely severed, as in the case of amputation, the axonal fibres regenerating from the cell body may never find their original route back to the muscle. Instead, they may form a traumatic neuroma, a painful collection of nerve fibres and myelin.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      13.8
      Seconds

  • Question 38 - A 78-year-old male presents to the Orthopaedic clinic with lower back pain for...

    Correct

    • A 78-year-old male presents to the Orthopaedic clinic with lower back pain for the past month. His past medical history reveals a history of cancer. After examination, you diagnose Metastatic Spinal Cord Compression (MSCC).

      Which one of the following cancers is this patient most likely to have had?

      Your Answer: Prostate cancer

      Explanation:

      Compression of the thecal sac causes metastatic Spinal Cord Compression (MSCC) due to a Metastatic tumour and its components. It can cause symptoms of limb weakness, sensory disturbances and back pain depending on the extent and level of Compression.

      The most common source of a tumour causing MSCC is a prostate carcinoma that metastasized to the spinal cord via the vertebral venous plexus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      11.1
      Seconds

  • Question 39 - Which one these is an example of a cause of an exudate? ...

    Correct

    • Which one these is an example of a cause of an exudate?

      Your Answer: Subphrenic abscess

      Explanation:

      An exudate is an inflammatory fluid emanating from the intravascular space due to changes in the permeability of the surrounding microcirculation.

      Some common causes of exudates are: pneumonia, empyema, lung cancer, breast cancer, cancer of the pleura, SLE, rheumatoid arthritis, pericarditis, subphrenic abscess, chylothorax.

      Myxoedema, nephrotic syndrome, congestive cardiac failure, and liver cirrhosis all cause TRANSUDATE.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      12.7
      Seconds

  • Question 40 - A 79-year-old male had a humeral shaft fracture during a road traffic accident...

    Correct

    • A 79-year-old male had a humeral shaft fracture during a road traffic accident and is being followed up in a fracture clinic. He complains of inability to use the limb 6 months after the injury. X-rays of that arm shows non union of his fracture.

      All the following are responsible for this non-union EXCEPT?

      Your Answer: Osteoporosis

      Explanation:

      An imbalance between bone resorption and formation is Osteoporosis. In normal bone, formation and resorption are roughly equal, and the density of bone matrix remains constant but there is more resorption in osteoporosis and the matrix density reduces and bones become weaker. Fractures are more likely to occur but healing is unaffected.

      Non-union of a fracture occurs when the two sides of a fracture fail to unite after 6 months. Causes include: infection, movement at the fracture site, avascular necrosis, tissue interposed between the fracture and gross misalignment.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      14.2
      Seconds

  • Question 41 - A patient with rash is examined. He has some redness of the skin...

    Correct

    • A patient with rash is examined. He has some redness of the skin that blanches when finger pressure is applied.

      What is the best description of this rash that you have found on examination?

      Your Answer: Erythema

      Explanation:

      Erythema is redness of the skin or mucous membranes caused by hyperaemia of superficial capillaries caused by skin injury, infection or inflammation. Erythema blanches when pressure is applied whereas ecchymosis, purpura and petechiae do not.

      Ecchymosis are discolouration of the skin or mucous membranes caused by extravasation of blood. They are usually red or purple in colour and measure greater than 1 cm in diameter and do not blanch on applying pressure.

      A macule is a flat, well circumscribed area of discoloured skin less than 1 cm in diameter with no changes in the thickness or texture of the skin.

      Petechiae are discolouration of the skin measuring less than 3 mm in diameter

      Purpura are discolouration of the skin measuring between 0.3 cm and 1 cm in diameter.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      6.7
      Seconds

  • Question 42 - You see a 30-year-old man who has come to the department with a...

    Correct

    • You see a 30-year-old man who has come to the department with a very tender right elbow. On examination, the elbow is very hot and red, and appears to be acutely inflamed.
      Which SINGLE statement regarding acute inflammation is FALSE?

      Your Answer: Reduced extravascular osmotic pressure leads to oedema

      Explanation:

      Inflammation can be divided intoacute inflammation, which occurs over seconds, minutes, hours, and days, andchronic inflammation, which occurs over longer periods.
      Acute inflammationcommences within seconds or minutes following the injury of tissues. There are numerous potential stimuli for an acute inflammatory response including infections (bacterial, viral, fungal, parasitic), tissue necrosis, foreign bodies, and Immune reactions (hypersensitivity reactions). The chief cell type of acute inflammation is the neutrophil.
      There are three main processesthat occur in the acute inflammatory response:
      Increased blood flow
      Increased capillary permeability
      Neutrophil migration
      1. Increased blood flow:
      Vasoactive mediators are released, such as nitric oxide, histamine, bradykinins, and prostaglandin E2. These mediators cause vasodilatation and increased blood flow to the area (causing redness and heat).
      2. Increased capillary permeability:
      The vasoactive mediators also cause increased capillary permeability by causing endothelial cell contraction that widens the intercellular gaps of venules. This allows an outpouring of protein-rich fluid (exudate) into the extracellular tissues that results in a reduction of intravascular osmotic pressure and an increase in extravascular/interstitial pressure. The increased interstitial osmotic pressure leads to oedema.
      3. Neutrophil migration:
      Neutrophils leave the vasculature through the following sequence of events:
      Margination and rolling: neutrophils flow nearer the vessel wall, rather than in the axial stream, which is referred to as margination. Following margination the neutrophils begin rolling along the surface of the vascular endothelium.
      Activation and adhesion: then as a result of interaction with endothelial cell adhesion molecules (CAMs) that is mediated by selectins, the neutrophils are activated and adhere to the endothelium.
      Transmigration: once bound to the endothelium, neutrophils squeeze through gaps between adjacent endothelial cells into the interstitial fluid, in a process calleddiapedesis.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      23.5
      Seconds

  • Question 43 - A 58-year-old man with a traumatic brain injury is brought into the...

    Correct

    • A 58-year-old man with a traumatic brain injury is brought into the ER. A medical student asks you about the processes that occur in the brain following a traumatic injury.

      One of these best describes the central nervous systems response to injury.

      Your Answer: Degeneration of the axon occurs proximally before it occurs distally

      Explanation:

      Following neuronal injury, as seen in traumatic brain injury, the axon undergoes anterograde degeneration. Degradation starts from the cell body (proximally) and progresses distally. The axon becomes fragmented and degenerates.

      The brain shows no reactive changes to injury is incorrect. Following major injury such as stroke, the brain undergoes a process of liquefactive degeneration, which leaves cystic spaces within the brain.

      Axonal regeneration does not occur to any significant extent within the central nervous system unlike what is seen in the peripheral nervous system.

      Astrocytes undergo reactive gliosis, leaving behind a firm translucent tissue around sites of damage.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9.4
      Seconds

  • Question 44 - A patient noticed ankle swelling and has passed very little urine over...

    Correct

    • A patient noticed ankle swelling and has passed very little urine over the past 24 hours. He also has nausea and vomiting, reduced urine output and his blood results reveal a sudden rise in his creatinine levels over the past 48 hours. You make a diagnosis of acute kidney injury (AKI).

      Which one of these is a prerenal cause of AKI?

      Your Answer: Cardiac failure

      Explanation:

      The causes of AKI can be divided into pre-renal, intrinsic renal and post-renal causes. Majority of AKI developing in the community is due to a pre-renal causes (90% of cases).

      Pre-renal causes: Haemorrhage, severe vomiting or diarrhoea, burns, cardiac failure, liver cirrhosis, nephrotic syndrome, hypotension, severe cardiac failure, NSAIDs, COX-2 inhibitors, ACE inhibitors or ARBs, Abdominal aortic aneurysm, renal artery stenosis, hepatorenal syndrome,

      Intrinsic (renal) causes:
      Eclampsia, glomerulonephritis, thrombosis, haemolytic-uraemic syndrome, acute tubular necrosis (ATN), acute interstitial nephritis, drugs ( NSAIDs), infection or autoimmune diseases, vasculitis, polyarteritis nodosa, thrombotic microangiopathy, cholesterol emboli, renal vein thrombosis, malignant hypertension

      Post-renal causes: Renal stones, Blood clot, Papillary necrosis, Urethral stricture, Prostatic hypertrophy or malignancy, Bladder tumour, Radiation fibrosis, Pelvic malignancy, Retroperitoneal fibrosis

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      296.8
      Seconds

  • Question 45 - A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited...

    Correct

    • A 40-year-old female presents to the orthopaedic clinic complaining of pain and limited range of motion in the right elbow for the past two days. On examination, the right elbow is extremely tender with erythema and warmth of the overlying skin due to acute inflammation.

      Which ONE of the following statements is true with regards to acute inflammation?

      Your Answer: Neutrophils are activated and adhere to the endothelium as a result of interaction with endothelial cell adhesion molecules

      Explanation:

      Acute inflammation is defined as inflammation occurring within minutes to hours in response to an injury lasting for less than two weeks.

      Acute inflammation
      Rapid onset (minutes to hours)
      Quick resolution (usually days)

      Chronic inflammation
      May last weeks, months, or years

      There are five cardinal signs of inflammation:
      1) Pain
      2) Redness
      3) Warmth
      4) Oedema
      5) Loss of function

      During acute inflammation, neutrophils are activated and attracted to the site of inflammation in response to various interleukins and cytokines. This process takes place via the following mechanism:
      1) Margination
      Neutrophils flow nearer the vessel wall rather than in the axial stream, which is referred to as margination
      2) Rolling along the surface of vascular endothelium
      3) Adhesion to the endothelium by interaction with adhesion molecules (ICAMS and VCAMS)
      4) Diapedesis is the movement of neutrophils from the endothelial cells into the interstitial space by squeezing through the gaps between adjacent endothelial cells

      Bradykinin and histamine are both responsible for vasodilation which causes oedema and decreases intravascular osmotic pressure.

      Neutrophils dominate early (<2 days)
      – Many in the bloodstream
      – Attach firmly to adhesion molecules
      – Apoptosis after 24-48hrs
      Monocytes/macrophages dominate late (>2 days)
      – Live longer
      – Replicate in tissues

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      13.4
      Seconds

  • Question 46 - A 66-year-old male was admitted from the Emergency Department due to severe pain...

    Correct

    • A 66-year-old male was admitted from the Emergency Department due to severe pain in the left forearm and hand, refractory to pain medication along with pallor and hypothermia of the affected limb. Ultrasound doppler showed an arterial embolism. Circulation was restored after vascular surgery, but there was extensive, irreversible muscle damage.

      How will the muscle heal from an injury of this type?

      Your Answer: Diffuse formation of fibrous tissue

      Explanation:

      Once muscle tissue is damaged, there will be healing via diffuse formation of fibrous tissue, especially due to the widespread ischemia.

      Callus formation takes place in the healing of bone, not muscle.

      Organised scar formation occurs when a lacerated wound is approximated by sutures so that primary intention wound healing can occur.

      Liquefaction degeneration occurs following ischemia in the brain.

      Volkmann’s ischemic contracture may occur, but it is not the primary type of healing that will take place but rather the effect of the fibrous scar formation.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      19.7
      Seconds

  • Question 47 - A 40-year-old man with reduced urine output, nausea, and confusion also has a...

    Correct

    • A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.

      His AKI stage is?

      Your Answer: Stage 2

      Explanation:

      This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).

      AKI stages are as follows:
      Stage 1
      Creatinine rise of 26 micromole/L or more within 48 hours, or
      Creatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),or
      Urine output <0.5 mL/kg/hour for more than 6 hours Stage 2
      Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),or
      Urine output <0.5 mL/kg/hour for more than 12 hours Stage 3
      Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), or
      Creatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, or
      Urine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      10.9
      Seconds

  • Question 48 - Common causes of exudates are infection, pericarditis, and malignancy.

    Which one statement about exudates...

    Correct

    • Common causes of exudates are infection, pericarditis, and malignancy.

      Which one statement about exudates is true?

      Your Answer: LDH levels are usually high

      Explanation:

      An exudate is an inflammatory fluid emanating from the intravascular space due to changes in the permeability of the surrounding microcirculation.

      Exudates are cloudy. It has high LDH levels, serum protein ratio >0.5, protein content >2.9g/dl, specific gravity of >1.020 and a serum-ascites albumin gradient (SAAG) of <1.2g/dl.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      19.1
      Seconds

  • Question 49 - A 40-year-old woman presents with a red, scaly, itchy rash around her navel...

    Correct

    • A 40-year-old woman presents with a red, scaly, itchy rash around her navel that occurred after contact with a nickel belt buckle. A diagnosis of allergic contact dermatitis is made. Which type of hypersensitivity reaction is this?

      Your Answer: Type IV hypersensitivity reaction

      Explanation:

      A type IV hypersensitivity reaction occurred in this patient. Allergic contact dermatitis is an inflammatory skin reaction occurring in response to an external stimulus, acting either as an allergen or an irritant, caused by a type IV or delayed hypersensitivity reaction. They usually take several days to develop.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      9.6
      Seconds

  • Question 50 - A 26-year-old female cuts her hand on a knife while preparing dinner but...

    Correct

    • A 26-year-old female cuts her hand on a knife while preparing dinner but the bleeding stops within a few minutes.

      Which one of the following cells will be among the first to be present at the wound site to be involved in haemostasis?

      Your Answer: Platelets

      Explanation:

      Platelets are the first cells to be attracted to the wound site due to the release of the Von Willebrand factor from the damaged endothelium. Platelets, in turn, release cytokines such as platelet-derived growth factor, which will attract other inflammatory cells to the wound site.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      8.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

General Pathology (43/50) 86%
Pathology (43/50) 86%
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